Evidence map›Paper›PMID 26833101›Full record

ReviewMetabolism: clinical and experimental2016

Guidelines on vitamin D replacement in bariatric surgery: Identification and systematic appraisal.

Marlene Toufic Chakhtoura, Nancy Nakhoul, Elie A Akl, Christos S Mantzoros, Ghada A El Hajj Fuleihan

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Metabolism: clinical and experimental, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 6 pooled it
8.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 6 syntheses or guidelines pooled it, 77 citations in OpenAlex.

  1. Pooled it
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  8. Vitamin DObesity surgery · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Marlene Toufic ChakhtouraDivision of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO, Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon; Scholars in HeAlth Research Program (SHARP), American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: mc39@aub.edu.lb.
Nancy NakhoulScholars in HeAlth Research Program (SHARP), American University of Beirut Medical Center, Beirut, Lebanon.
Elie A AklDepartment of Internal Medicine, American University of Beirut, Beirut, Lebanon.
Christos S MantzorosDepartment of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Ghada A El Hajj FuleihanDivision of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO, Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon.
American University of Beirut Medical Center · LBAmerican University of Beirut · LBBeth Israel Deaconess Medical Center · US

Funding

Genetic and Metabolic Determinants of 25(OH)D levels at Baseline and One Year: Findings from a Dose Ranging Vitamin D trialD43TW009118 · FIC · AMERICAN UNIVERSITY OF BEIRUT · PI FULEIHAN, GHADA ELHAJJ · 2012 to 2024
$2.5M
FIC NIH HHS D43 TW009118
6 · The paper itself

Abstract

introductionBariatric surgery is the most effective therapeutic option to reduce weight in morbidly obese individuals, but it results in a number of mineral and vitamin deficiencies. Clinical Practice Guidelines (CPGs) attempt to balance those benefits and harms to provide guidance to physicians and patients.

objectivesWe compare and evaluate the quality of the evidence and of the development process of current CPGs that provide recommendations on vitamin D replacement in patients undergoing bariatric surgery, using a validated tool.

methodsWe searched 4 databases, with no time restriction, to identify relevant and current CPGs. Two reviewers assessed eligibility and abstracted data, in duplicate. They evaluated the quality of CPGs development process using the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) tool that consists of 6 domains. A content expert verified those assessments.

resultsWe identified 3 eligible CPGs: (1) the Endocrine Society (ES) guidelines (2010); (2) the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), and the American Society for Metabolic & Bariatric Surgery (ASMBS) guidelines (update 2013); and (3) the Interdisciplinary European (IE) guidelines on Metabolic and Bariatric Surgery (latest update 2014). The ES and the AACE/TOS/ASMBS guidelines recommended high doses of vitamin D, varying from 3000IU daily to 50,000IU 1-3 times weekly. Vitamin D doses were not mentioned in the IE guidelines. The recommendations were based on a low quality of evidence, if any, or limited to a single high quality trial, for some outcomes. In terms of quality, only the IE guidelines described their search methodology but none of the CPGs provided details on evidence selection and appraisal. None of the three CPGs rigorously assessed the preferences of the target population, resource implications, and the applicability of these guidelines. According to the AGREE II tool, we rated the ES guidelines as average in quality, and the other two as low in quality.

conclusionCurrent CPGs recommendations on vitamin D supplementation in bariatric surgery differ between societies. They do not fulfill criteria for optimal guideline development, in part possibly due to limited resources, and are based on expert opinion. Thus, the pressing need for high quality randomized trials to inform CPGs, to be developed based on recommended standards.

Indexed as

Guidelines as TopicBariatric SurgeryDietary SupplementsHumansObesity, MorbidPostoperative ComplicationsVitamin DVitamin D DeficiencyVitaminsVitamin DVitaminsAppraisal toolBariatric surgeryClinical practice guidelinesQuality of evidenceVitamin D replacement

Identifiers

PMID26833101
PMCPMC4792722
OpenAlexW2209898201

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.